States Are Transforming the Way They Treat Drug Addicts

Breann Johnson stopped using heroin on Mother’s Day this year, determined to end her 13-year addiction. Days later, she began three months of residential treatment in Riverside, Calif. — all paid for by California’s Medicaid program.

Johnson, who has two young sons, said other inpatient drug rehab programs had refused to accept Medicaid, and she knew outpatient care would not be enough to break her habit.

“I couldn’t stop,” said Johnson, 28. “With my drug, you are either sick all day or you have to do it to make yourself feel better.”

As the opioid epidemic burns a path of devastation through communities across the nation, California is leading the way in revamping treatment for low-income residents like Johnson. Before this year, the state’s Medicaid program, known as Medi-Cal, covered only limited and episodic care. Now, it pays for a much broader range of treatment including expanded access to medications, inpatient beds, individual therapy and case managers.

The five-year pilot project, which gives the state flexibility in its use of federal money, was approved in 2015 by the agency that oversees Medicaid. The California project officially started earlier this year. Virginia, Massachusetts and Maryland also have federal permission to expand drug treatment for Medicaid members. Other states, including West Virginia and Michigan, are seeking it.

California’s drug rehab overhaul makes it easier for Medi-Cal members to get care and improves their chances of long-term recovery, state health officials said. It also aims to reduce costs by decreasing use of emergency rooms and hospitals and keeping drug-addicted enrollees out of jail and out of the child welfare system.